PLAIN LANGUAGE SUMMARY In Canada, the CADTH Common Drug Review helps ensure that scarce health care resources are used to fund the most effective drugs. Clinicians, researchers, payers, and patients all have important, but potentially different, ideas on what should be considered, to determine a drug's value. Since 2010, CADTH has invited patient groups to contribute their perspectives to the Common Drug Review. We explored whether, and how, insights offered by patient groups are integrated into assessment reports and Recommendations by the CADTH Canadian Drug Expert Committee. After examining 30 completed drug assessments, we found that:Patient insights are used by CADTH reviewers to frame an assessment and are used by the expert committee to interpret the evidence.Drug trials do not always measure outcomes that patients consider important.Survival, symptom relief, the process of recovery, and maintaining health are all important aspects to consider when determining value during health technology assessments. ABSTRACT Background Since 2010, Canadian patient groups have contributed to the CADTH Common Drug Review (CDR). CADTH conducts health technology assessments of new drugs to support publicly funded drug plans' reimbursement decisions. We explored whether, and how, patient insights were integrated into assessment reports and Recommendations by the CADTH Canadian Drug Expert Committee (CDEC). Methods We descriptively analyzed 30 consecutive assessments. One researcher identified a set of issues, insights, and desired treatment outcomes provided by patient groups for each included drug assessment. We tracked the presence of each identified patient insight in the relevant assessment protocol, in clinical trials as reported in the assessment, and in the CDEC Recommendations. Additionally, patient insights were categorized by topic and grouped into a three-tier framework to explore the observed juxtaposition between immediate treatment outcomes as seen in clinical trials and the insights from patients living with a chronic condition. Results In 30 drug assessments, 119 patient insights were identified. Of these insights, 89 were included in assessment protocols; 61 in reported clinical trial data; and 67 insights were reflected upon within the CDEC Recommendations. Patient insights within the first framework tier (health status achieved) were frequently included in all aspects of CDR assessments. Within the second tier (progress of recovery), although two-thirds of patient insights were included in protocols, only one-third was reflected in reported trial data or in CDEC Recommendations. Insights within the third tier, which address the long-term consequences of illness and treatment, were even less frequently addressed in all aspects of CDR assessments. Conclusions Patients' perspectives need not be "considered" in isolation. Patient insights are used by CADTH reviewers to frame an assessment and used by CDEC to interpret the evidence. As health technology assessments should address the indirect and unintended consequences of a technology, as well as its direct and intended effects, drug assessments should consider the progress of recovery and sustainability of health, in addition to survival and immediate health achieved.

中文翻译：

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患者的观点可以整合到健康技术评估中：CADTH Common Drug Review 的探索性分析。

简明语言摘要 在加拿大，CADTH 通用药物审查有助于确保将稀缺的医疗保健资源用于资助最有效的药物。临床医生、研究人员、付款人和患者对于应该考虑什么来确定药物的价值都有重要但可能不同的想法。自 2010 年以来，CADTH 已邀请患者团体为 Common Drug Review 贡献他们的观点。我们探讨了患者群体提供的见解是否以及如何整合到 CADTH 加拿大药物专家委员会的评估报告和建议中。在检查了 30 项已完成的药物评估后，我们发现： CADTH 审稿人使用患者见解来构建评估，并由专家委员会用于解释证据。药物试验并不总是衡量患者认为重要的结果。在健康技术评估期间确定价值时，生存、症状缓解、恢复过程和健康都是要考虑的重要方面。摘要背景 自 2010 年以来，加拿大患者团体为 CADTH 通用药物审查 (CDR) 做出了贡献。CADTH 对新药进行健康技术评估，以支持公共资助药物计划的报销决定。我们探讨了 CADTH 加拿大药物专家委员会 (CDEC) 是否以及如何将患者见解整合到评估报告和建议中。方法 我们描述性地分析了 30 个连续的评估。一位研究人员确定了患者组为每个包含的药物评估提供的一组问题、见解和期望的治疗结果。我们在相关评估方案、评估报告的临床试验和 CDEC 建议中跟踪了每个确定的患者洞察力的存在。此外，患者见解按主题分类，并分为三层框架，以探索在临床试验中观察到的即时治疗结果与慢性病患者的见解之间的并列。结果 在 30 项药物评估中，确定了 119 名患者的见解。在这些见解中，有 89 项包含在评估协议中；报告的临床试验数据为 61；CDEC 建议中反映了 67 条见解。第一框架层级（达到的健康状况）中的患者见解经常包含在 CDR 评估的所有方面。在第二层（恢复进度）内，尽管三分之二的患者见解包含在方案中，但只有三分之一反映在报告的试验数据或 CDEC 建议中。第三层的洞察力，解决疾病和治疗的长期后果，在 CDR 评估的所有方面都很少得到解决。结论 患者的观点不必孤立地“考虑”。CADTH 评审员使用患者见解来构建评估，CDEC 使用患者见解来解释证据。卫生技术评估应解决技术的间接和非预期后果，以及其直接和预期效果，药物评估应考虑恢复的进展和健康的可持续性，以及实现的生存和即时健康。